Phone medical appointments for sleep-disordered breathing in Covid-19 pandemic - were they useful?

Introduction: The WHO declared the COVID-19 outbreak as a pandemic. The ability to integrate telecommunications and information systems was crucial. Aims: To evaluate the usefulness of teleconsultations and telemonitoring in Sleep-disordered breathing (SDB) patient’s follow-up. Methods: The study was conducted at the Sleep Lab of a tertiary university hospital between 13th march and 31st May 2020. All patients included were adults with suspected or confirmed SDB. In the first phone medical appointments, a clinical interview was conducted. In the follow-up teleconsultations, all patients had SDB and we analyzed adherence to treatment, control of respiratory sleep events, PAP-related side effects, and changes in therapeutic strategies. Results: A total of 769 phone consultations were performed. In first phone medical appointments (n=149), 109 patients answered the call. In follow-up teleconsultations (n=620), 89,7% answered the call and 86,8% were under PAP-therapy. Information of PAP devices was available in 354 cases; 79.1% of patients had adequate adherence and 76% had residual AHI≤5 events/h. A new therapeutic approach was more often started in patients with nasal congestion (pl.001), rhinorrhea (pl.001), and nosebleeds (p=0.03). Changes in previous therapy were more frequent in patients with nasal congestion (pl.001), rhinorrhea (pl.001), mucosal dryness (pl.001), and nosebleeds (p=0.02). Patients whose PAP settings were changed had a higher median residual AHI, median 5 (8) events/h vs median 2 (3) events/h, pl.001. Conclusions: Teleconsultation and telemonitoring of SDB patients are possible in most cases and allow the resolution of several side effects and therapeutic adjustments.